Anesthetic Management for 12 Patients with Myasthenia Gravis / 대한마취과학회지

ABSTRACT

Serious complications and death may occur in patients with neuromuscular disorders after administration of muscle relaxants that include prolonged paralysis, hyperkalemia, muscle rigidy and malignant hyperthermia. Myasthenia gravis, neuromuscular junctional lestion, is a postsynaptic autoimmune disease that reduces the acetylcholine receptor population. Those with myasthenia gravis like patients with other neuromuscular disorders respond abnormally to administration of depolarizing and non-depolarizing neuromuscular blocking agents. Therefore, many anesthesiologists avoid the use of muscle relaxants in general anesthesia for these patients, but the use of volatile anesthetics, premedicants, anticholiesterases and other drugs also have drawbacks. Special precautions should be taken with patients with myasthenia gravis to avoid interaction of muscle relaxants and other drugs at the neuromuscular junction in the anesthetic management during surgery and perioperative serious complications.